Application to the head physician of the clinic about refusal to issue a prescription. The doctor cannot refuse to write a preferential prescription

Good afternoon.

1. To receive discounted medications At the pharmacy you need to write out a prescription for them from your local doctor. The basis for issuing a prescription is a written recommendation (extract) received from a specialized medical institution where the patient is observed for his underlying disease.
2. The local doctor may refuse to issue a prescription due to lack of this drug at the pharmacy. This refusal is illegal, because even if the drug is not available this moment at a pharmacy, upon receipt of a prescription, the pharmacy is obliged to purchase the drug specified in the prescription within ten days. If there is no prescription, then the pharmacy is not obliged to do ANYTHING, and you will never see the medicine. Therefore, you need to “remind” your local doctor about this and continue to insist on writing out a prescription. 3. If the doctor continues to refuse to issue a prescription, demand it and write it down on the card: “the prescription was not issued due to the lack of medicine in the pharmacy.” He cannot write something like that, so he will either write out a prescription or refuse to write down on the card that he did not write it out. In this case, it is necessary that the doctor MUST make an entry in the card stating that the patient on such and such a date was at an appointment and was examined by a doctor on such and such (he will not be able to refuse this).
4. Immediately after leaving the doctor’s office, write a complaint in 2 copies addressed to the head doctor of the clinic with approximately the following content: “To the head doctor so-and-so from so-and-so... Please explain on what basis the therapist so-and-so refused to write me a prescription for medicine (name) , necessary for my life's indications. I consider this refusal illegal on the basis of the Order of the Ministry of Health and social development RF dated 02/12/2007 N 110, RF Government Decree dated 07/30/1994 No. 890...
5. Give one copy of the letter to the secretary of the head physician, ask the secretary to put a stamp on the second copy.
6. If the secretary refuses to accept the complaint, you must send it by mail - registered mail with a list of attachments and acknowledgment of delivery. The inventory will be given in two copies, one to be placed in the letter, the second to be attached to a copy of the complaint stored in your home. Attach the payment receipt there registered letter and a notice of receipt of the complaint signed by the secretary of the head physician. 7. In the future, act depending on the reaction of the head physician. He may offer to agree verbally, but it is necessary to insist on a written response. After this, a prescription for the medicine is usually given.
8. If unsubscribes begin (they are prohibited from writing out this medicine in the Department of Health, there is no money in the budget, etc.), then you need to contact the prosecutor’s office, the regional Ministry of Health, Roszdravnadzor (you can go to 3 of these places at once). Send there COPIES (not originals) of all documents (your complaint, postal documents - list of attachments, receipt, delivery of notification; responses from the head physician). If there was no response from the head physician, you can safely complain to the prosecutor’s office. Usually, after a complaint to the prosecutor's office, doctors themselves call home and ask when it is convenient for you to come for a prescription.

Everyone faces the impossibility of obtaining free medicine prescribed by the attending physician. large quantity patients. The reason for this is not only the frequent absence the necessary drugs in pharmacies, but also the dishonesty of their employees who refuse to serve beneficiaries. How to protect your rights?

According to the requirements of Roszdravnadzor, there is a clear algorithm of actions that the pharmacist must adhere to if the pharmacy does not have the subsidized medicine needed by the patient. But not all citizens know about it. Therefore, upon hearing a refusal, they purchase expensive drugs with personal funds, while leaving violators of their rights without punishment.

What should a pharmacy employee do if there are no subsidized medications?

If the free drugs prescribed by the doctor are not available at the pharmacy at the time of the patient’s request, the pharmacist has the right to offer available ones. similar means. If the client refuses to receive substitute medications, then the pharmacist is obliged to act according to the following algorithm:

1. Accept from patient preferential prescription.
2. Register it in a special pharmacy journal of unmet demand, assigning it the status of deferred maintenance.
3. Enter recipe details into electronic program institutions.
4. Submit a written/electronic request for medications to the supplier company.

The authorized pharmaceutical organization must also register the incoming request and provide an official response to the pharmacy regarding the presence/absence and availability of this drug. If the application cannot be satisfied on its part, the pharmacy must purchase the drug itself, and the costs incurred will subsequently be compensated by the state.

If the drug is not available in the pharmacy indicated by the doctor who wrote the preferential prescription, the patient has the opportunity to get it at another social pharmacy, provided that it is located on the territory of the same municipality, and the heads of both institutions agreed on this point among themselves. If the drug is not available in the right dosage, the pharmacist can replace it with a medicine with a lower dosage, but increasing its volume to an amount that will be sufficient for therapy. At the same time, to issue funds in higher dosage than prescribed, you must contact your doctor for a different prescription. None pharmacy establishment does not have the right to limit the volume of subsidized medicine. Only the attending doctor has this competence.

How long does it take for the pharmacy to provide medications?

Roszdravnadzor allocates 10 working (not calendar!) days for the delivery of previously unavailable medications. If the drugs were prescribed through medical commission, then this period increases to 15 days. Notification of the customer about the arrival of the order is often made by telephone on the same day when necessary funds arrived at the pharmacy.

Where should I file a complaint against a pharmacy?

If, after the specified period, the delivery of the missing medicine was not carried out, or the pharmacist completely refused to serve the client with a preferential prescription, you can first try to resolve the controversial situation by filing a complaint with the manager of the pharmacy. If the violation is not eliminated, you must file an oral or written complaint against the establishment, outlining the essence of the problem. Below are the main ways to file a complaint against a social pharmacy that violates the rights of a beneficiary to receive medicines:

• Call the hotline of the Department of Health of your city/region. You can find out its number from the help desk operators or on the structure’s website, where you can also familiarize yourself with the specialists’ work schedule;
• Contact operators « hotline» Pharmacy Department of the Department of Health of your city/region, having found out its contact information in a similar way;
• Leave a request on the official website of Roszdravnadzor, indicating your contact details, name and address of the pharmacy, detailed description the situation;
• Contact the administration of the clinic where the preferential prescription was issued. The specialist on duty is engaged in the solution controversial issues problems encountered by patients, including the provision of subsidized medications. Information about his work schedule, as well as a contact phone number, can be obtained from the reception desk;
• Submit an application to the prosecutor's office against the organization or official who created obstacles to the patient receiving free medicines, attaching copies of the passport, beneficiary ID, and prescription.

Each pharmacy has the right to refuse to issue a medicine to a person if the preferential prescription was not written on an official form or its validity period has expired. In this case, complaints against the pharmacy will not be considered. And the patient will need to contact his doctor with a request for a new prescription.

• 24. 11. 2016

What do doctors and officials do to avoid giving patients their dues? free medicines

"You are not sick." “That’s not what you’re sick with.” "You don't need this medicine." “You need this medicine, but another, cheaper one will also do.” “You need this drug, but it’s not there, wait.” This is how doctors and officials respond to thousands of people who are entitled to subsidized medicine by law. They are deceiving. They know that a person is sick and they know what medicine he needs. But according to rough estimates, the state is already short of 45 billion rubles for drug provision. . In some regions, only 10% of those who apply can be provided with subsidized drugs. Officials and doctors refuse patients in such a way as to make breaking the law as difficult as possible to prove. The Ministry of Health and Roszdravnadzor regularly report: the situation with preferential drug coverage in the country is stable. The numbers underlying these reports have no relation to reality. The true scale and cruelty of the war between patients and the state is amazing

“Every time they say: “Sorry, there are no medicines!” I can’t help it!” But they are entitled to me by law. If they are not available today, the state must purchase them tomorrow. Is not it so?"

Veronica has repeated this question many times, but her voice still sounds surprised. When she speaks, her hands with long, graceful fingers tremble slightly, as if she, too, cannot contain her amazement. She has been taking hormonal inhalers for 15 years and cannot breathe without them. She has asthma, lots of concomitant diseases and disability. She has the right to receive free the dose she needs is at the pharmacy, but the medicine has not been given out for a year and a half.

“They were always issued intermittently,” says Veronica. “We had to find out in advance the day when the drug would appear, and run to the clinic when it opened in order to get it in time.” If you don’t have time, they’ll say it’s over, and do whatever you want. But I only came across the fact that there are no medicines for months last year.”

The pharmacy said that there was no point in asking - there would be no medicine.

Then, after six months of waiting, Veronica first contacted the Moscow Department of Health. All you had to do was leave a request, and the inhaler, which was missing from the pharmacy in the morning, was found in the evening. But the magical effect of calling the department did not last long. After a couple of months, the medications were stopped being given again. This time, when Veronica called the department, she was told that the situation was complicated. You can leave an application, but no one knows when the drugs will be available. On the same day, she received a call from the pharmacy and was told that there was no point in asking - there would be no medicine. Now Veronica’s relatives buy inhalers, the amount is several thousand rubles a month. According to Veronica, for many people waiting in line to see a pulmonologist, this amount is unaffordable. The words “there are no cures” sound like a death sentence for them.

Veronica's case is one of thousands. It is enough to leaf through the regional press for last month to read a dozen such stories. In Mordovia, pharmacies for beneficiaries do not have not only prednisolone, but even iodine and bandages. In the Oryol region, a woman with lymphoma managed to get medicine only after local media wrote about this case. In Khakassia, due to the huge number of patient complaints, the situation with preferential medicines will be investigated by the Chamber of Control and Accounts. Organizations involved in protecting patients' rights constantly talk about the growing number of requests. Such growth is recorded, for example, by the Movement Against Cancer society. In September of this year, cases of refusal to people with oncological diseases there were so many that the General Prosecutor’s Office dealt with violations of the law in a number of regions. According to online monitoring as of September 2016, conducted by the head of the League of Patients society, Alexander Saversky, more than 80% of respondents experience difficulties in obtaining subsidized medications. Only 35% of them manage to obtain a prescription for the drug without any problems. Similar figures were given in last year’s monitoring by the All-Russian Popular Front: half of the patients who apply for medications are not given medications on time.

Illustration: Rita Cherepanova for TD

A 2016 government report stated that about 45 billion rubles are missing for drug provision.. This is not surprising: the standard cost per citizen receiving free drugs decreased from 849 rubles per month in 2011 to 758 rubles in 2016. At the same time, according to Rosstat, drug prices have increased by 24% this year. In 2015, the government even allocated an additional 16 billion rubles to save the situation - but they unexpectedly turned out to be not in demand. The Ministry of Health stated that everything necessary medications purchased.Roszdravnadzor regularly monitors the drug supply in the country and is satisfied with its results. According to reports from these departments, in the Moscow region, for example, about 98% of beneficiaries receive drugs, and in other regions the situation is stable. The ability of the Ministry of Health to force health officials to shape reality in accordance with reporting goals surprises even the president.

If not in a good way

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